Muscle relaxants for nonspecific low back pain: A systematic review within the framework of the Cochrane Collaboration

Spine

Volumn 28, Issue 17, 2003, Pages 1978-1992

  Van Tulder, Maurits W ^a   Touray, Tony ^a   Furlan, Andrea D ^b   Solway, Sherra ^b   Bouter, Lex M ^a  

^a VU UNIVERSITY MEDICAL CENTER   (Netherlands)

^b INSTITUTE FOR WORK AND HEALTH   (Canada)

Author keywords

Cochrane Collaboration; Effectiveness; Low back pain; Muscle relaxants; Systematic review

Indexed keywords

ACETYLSALICYLIC ACID; ACETYLSALICYLIC ACID CALCIUM; ANALGESIC AGENT; BACLOFEN; BENZODIAZEPINE; CARISOPRODOL; CHLORZOXAZONE; CODEINE; CYCLOBENZAPRINE; DANTROLENE; DIAZEPAM; ETHOHEPTAZINE; FLUPIRTINE; LEVOMEPROMAZINE; MEFENAMIC ACID; MEPROBAMATE; METAXALONE; METHOCARBAMOL; MUSCLE RELAXANT AGENT; NONSTEROID ANTIINFLAMMATORY AGENT; ORPHENADRINE; PARACETAMOL; PHENOBARBITAL; PRIDINOL MESILATE; SPASMOLYTIC AGENT; TETRAZEPAM; THIOCOLCHICOSIDE; TIZANIDINE; TOLPERISONE; UNINDEXED DRUG;

ADOLESCENT; ADULT; AGED; ANALGESIA; CLINICAL PRACTICE; CLINICAL TRIAL; COCHRANE LIBRARY; COMPUTER ANALYSIS; CONFIDENCE INTERVAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; DROWSINESS; DRUG EFFICACY; EMBASE; FEMALE; GASTROINTESTINAL SYMPTOM; HUMAN; LIVER TOXICITY; LOW BACK PAIN; MAJOR CLINICAL STUDY; MALE; MEDLINE; META ANALYSIS; MULTICENTER STUDY; MUSCLE WEAKNESS; NAUSEA; NEUROTOXICITY; OUTCOMES RESEARCH; PAIN ASSESSMENT; PRIORITY JOURNAL; QUALITATIVE ANALYSIS; QUALITY CONTROL; QUANTITATIVE ANALYSIS; RANDOMIZED CONTROLLED TRIAL; REVIEW; STATISTICAL ANALYSIS; STEVENS JOHNSON SYNDROME; TOXIC EPIDERMAL NECROLYSIS; TREATMENT INDICATION; TREATMENT OUTCOME; VERTIGO;

CONTROLLED CLINICAL TRIALS; DOUBLE-BLIND METHOD; HUMANS; LOW BACK PAIN; MUSCLE RELAXANTS, CENTRAL; RANDOMIZED CONTROLLED TRIALS; TREATMENT OUTCOME;

EID: 0042836472     PISSN: 03622436     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.BRS.0000090503.38830.AD     Document Type: Review

References (84)

1. Cherkin DC, Wheeler KJ, Barlow W, et al. Medication use for low back pain in primary care. Spine 1998;23:607-14.
2. Jackson, MD, Ryan DM. Drugs of importance in rehabilitation. In: Rehabilitation Medicine: Principles and Practice. DeLisa JA, ed. Philadelphia, PA: J.B. Lippincott; 1993.
3. Lofland JH, Szarlej D, Buttaro T, et al. Cyclobenzaprine hydrochloride is a commonly prescribed centrally acting muscle relaxant, which is structurally similar to tricyclic antidepressants (TCAs) and differs from amitriptyline by only one double bond. Clin J Pain 2001;17:103-4.
4. Pratzel HG, Alken R-G, Ramm S. Efficacy and tolerance of repeated oral doses of tolperisone hydrochloride in the treatment of painful reflex muscle spasm: results of a prospective placebo-controlled double-blind trial. Pain 1996;67:417-25.
5. Sirdalud Ternelin Asia-Pacific Study Group. Efficacy and gastroprotective effects of tizanidine plus diclofenac versus placebo plus diclofenac in patients with painful muscle spasms. Curr Ther Res 1998;59:13-22.
6. Rosche J. Treatment of spasticity. Spinal Cord 2002;40:261-2.
7. Abbruzzese G. The medical management of spasticity. Eur J Neurol 2002;9(suppl 1):30-4.
8. Elder NC. Abuse of skeletal muscle relaxants. Am Fam Phys 1991;44:1223-6.
9. Koes BW, van Tulder MW, Ostelo R, et al. Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 2001;26:2504-13.
10. Di Iorio D, Henley E, Doughty A. A survey of primary care physician practice patterns and adherence to acute low back problem guidelines. Arch Fam Med 2000;9:1015-21.
11. Johnson EW. The myth of skeletal muscle spasm. Am J Phys Med Rehabil 1989;68:1.
12. Littrell R, Hayes L, Stilllner V. Carisoprodol (Soma). A new and cautious perspective on an old agent. South Med J 1993;68:753-6.
13. Browning R, Jackson JL, O'Malley PG. Cyclobenzaprine and back pain: a meta-analysis. Arch Intern Med 2001;161:1613-20.
14. van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine 1997;22:2128-56.
15. Roujeau JC, Kelly JP, Naldi L, et al. Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. N Engl J Med 1995;333:1600-7.
16. Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. Br Med J 1994;309:1286-91.
17. Bigos S, Bowyer O, Braen G. Acute low back problems in adults. Clinical Practice Guideline no. 14. AHCPR publication no. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Services, U.S. Department of Health and Human Services; 1994.
18. Baptista R, Brizzi J, Dutra F, et al. Terapeutica da lombalgia com a tizanidina (DS 103-282), un novo agente mioespasmolitico. Estudo multicentrico, duplo-cego e comparativo. Folha Medica 1988;96(3):119-123.
19. Bianchi M. Evaluation of cyclobenzaprine for skeletal muscle spasm of local origin. Clinical evaluation of Flexeril (Cyclobenzaprine HCL/MSD). Minneapolis, MN: Postgraduate Medicine Communications; 1978:25-9.
20. Bragstad A, Blikra G. Evaluation of a new skeletal muscle relaxant in the treatment of low back pain (a comparison of DS 103-282 with chlorzoxazone). Curr Ther Res 1979;26:39-43.
21. Corts Giner JR. Estudio DS 103-282: relajante muscular en lumbalgia aguda o lumbago (estudio doble ciego de tizanidina + paracetamol vs. placebo + paracetamol). Rev Esp de Cir Ost 1989;119-24.
22. Hennies O. A new skeletal muscle relaxant (DS 103-282) compared to diazepam in the treatment of muscle spasm of local origin. J Int Med Res 1981;9:62-8.
23. Lepisto P. A comparative trial of DS 103-282 and placebo in the treatment of acute skeletal muscle spasms due to disorders of the back. Ther Res 1979;26:454-9.
24. Pipino F, Menarini C, Lombardi G, et al. A direct myotonolytic (pridinol mesilate) for the management of chronic low back pain: a multicentre, comparative clinical evaluation. Eur J Clin Res 1991;1:55-70.
25. Salzmann E, Pforringer W, Paal G, et al. Treatment of chronic low-back syndrome with tetrazepam in a placebo controlled double-blind trial. J Drug Dev 1992;4:219-28.
26. Weber H. Comparison of the effect of diazepam and levomepromazine on pain in patients with acute lumbago-sciatica. J Oslo City Hosp 1980;30:65-8.
27. Van Tulder MW, Assendelft WJ, Koes BW, et al. Method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group for Spinal Disorders. Spine 1997;22:2323-30.
28. Farrar JT, Portenoy RK, Berlin JA, et al. Defining the clinically important difference in pain outcome measures. Pain 2000;88:287-94.
29. Farrar JT, Young JP, LaMoreaux L, et al. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical rating scale. Pain 2001;94:149-58.
30. Aiken DW. Cyclobenzaprine in the treatment of acute skeletal muscle spasm of local origin. Clinical evaluation of Flexeril (Cyclobenzaprine HCL/MSD). Minneapolis, MN: Postgraduate Medicine Communications; 1978:30-3.
31. Aiken DW. A comparative study of the effects of cyclobenzaprine, diazepam, and placebo on acute skeletal muscle spasm of local origin. Clinical evaluation of Flexeril (Cyclobenzaprine HCL/MSD). Minneapolis, MN: Postgraduate Medicine Communications; 1978:34-8.
32. Aoki T, Kawaji W, Miyoshi K, et al. Clinical evaluation of NK433 (Lanperisone Hydrochloride), a new centrally acting muscle relaxant on lumbago. Jpn Pharmacol Ther 1995;23:255-84.
33. Basmajian JV. Acute back pain and spasm: a controlled multicenter trial of combined analgesic and antispasm agents. Spine 1989;14:438-9.
34. Bercel NA. Cyclobenzaprine in the treatment of skeletal muscle spasm in osteoarthritis of the cervical and lumbar spine. Curr Ther Res 1977;22:462-8.
35. Bobulesco V, Triandat I. Contributions a l'etude de l'experimentation clinique d'une association entre le chlorzoxosone et le dimethyl-amino-antypirine (Oferol). Rev Med Chir Soc Med Nat Lasi 1970;74:729-33.
36. Bouchier-Hayes T. Chlormezanone in low back pain and wryneck: an "analgesic" sparing effect. Br J Clin Pract 1984;38:259-62.
37. Brown BR, Womble J. Cyclobenzaprine in intractable pain syndromes with muscle spasm. JAMA 1978;240:1151-2.
38. Fryda-Kaurimsky Z, Muller-Fassbender H. Tizanidine (DS 103-282) in the treatment of acute paravertebral spasm: a controlled trial comparing tizanidine and diazepam. J Int Res 1981;9:501-5.
39. Gabric S. The effect of tizanidine and tenoxicam in patients with low back pain by electrokinesiologic analyses. Pharmaca 1992;30:1-4.
40. Hasue M, Tachibana S, Kunogi J, et al. Clinical evaluation of Eperisone Hydrochloride Tape (E2000) in lumbago, cervicobrachial syndrome, and periarthritis humeroscapularis. Jpn Pharmacol Ther 1997;25:207-25.
41. Hofferberth R, Schreiner H. Ein beitrag zur medikamentosen therapie des akuten LWS-syndroms. Zeitschrift Allgemeinmedizin 1994;70:738-42.
42. Kuroki Y, Sugimori H, Yasuno K, et al. The clinical evaluation of Lanperisone hydrochloride (NK433), a new centrally acting muscle relaxant, on cervicobrachial syndrome and lumbago with myotonic pains. Jpn Pharmacol Ther 1995;23:287-99.
43. Larouche SJ, Block G, Raskin S, et al. Controlled trial of cyclobenzaprine for acute musculoskeletal spasm. Clin Pharmacol Ther 1999;65:120.
44. Marcel C, Rezvani Y, Revel M. Evaluation du thocolchicoside en monotherapie dans le lumbago douloreuz: Resultats d'une etude randomisee contre placebo. La Presse Medicale 1990;24:1133-6.
45. McGuinness BW, Lloyd-Jones M, Fowler PD. A double-blind comparative trial of 'Parazolidin' and paracetamol. Br J Clin Pract 1969;23:452-5.
46. McGuinness B. A double-blind comparison in general practice of a combination tablet containing orphenadrine citrate and paracetamol ('Norgesic') with paracetamol alone. J Int Med Res 1983;11:42-5.
47. Meignany F. Interet de la pommade Srilane dans ke traitement symptomatique des lombalgies chroniques. Rev Int Rhumatol 1991;21:23-6.
48. Middleton R. A comparison of two analgesic muscle relaxant combinations in acute back pain. Br J Clin Pract 1984;38:107-9.
49. Nibbelink DW, Strickland SC, McLean LF, et al. Cyclobenzaprine, diazepam and placebo in the treatment of skeletal muscle spasm of local origin. Clin Ther 1978;1:409-24.
50. Preston EJ, Miller CB, Herbertson RK. A double-blind, multicenter trial of Methacarbamol (Robaxin) and cyclobenzaprine (Flexeril) in acute musculoskeletal conditions. Today's Ther Trends 1984;1:1-11.
51. Scheiner JJ. Cyclobenzaprine in the treatment of local muscle spasm: comparison with diazepam and placebo. Clinical evaluation of Flexeril (Cyclobenzaprine HCL/MSD). Minneapolis, MN: Postgraduate Medicine Communications; 1978:39-47.
52. Stehman M. Double-blind clinical study of Idrocilamide ointment in the treatment of acute low back pain. Acta Belg Med Physica 1990;13:29-32.
53. Steingard PM, Schildberg WL, Peterson KD. Multiclinic study of a muscle relaxant for treatment of acute musculoskeletal disorders. Osteopath Ann 1980;8:44-58.
54. Tessari L, Fasoli M. "Musco-Ril": attivita antiflogistica ed analgesica: sperimentazione clinica policentria su un farmaco decontratturante. Minerva Med 1968;59:4645-64.
55. Valtonen EJ. A double-blind trial of methocarbamol versus placebo in painful muscle spasm. Curr Med Res Opin 1975;3:382-5.
56. Vernon W. A double-blind evaluation of Parafon Forte in the treatment of musculo-skeletal back conditions. Curr Ther Res 1972;14:801-6.
57. Yakhno N, Damulin I, Chernenko O, et al. Sirdalud efficacy in chemotherapy of spinal pain. Ter Arkh 1994;66:10-12.
58. Arbus L, Fajadet B, Aubert D, et al. Activity of tetrazepam in low back pain. Clin Trials J 1990;27:258-67.
59. Basmajian J. Cyclobenzaprine hydrochloride effect on skeletal muscle spasm in the lumbar region and neck: two double-blind controlled clinical and laboratory studies. Arch Phys Med Rehabil 1978;59:58-63.
60. Moll W. Zur therapie akuter lumbovertebraler syndrome durch optimale medikamentose muskelrelaxation mittels diazepam. Med Welt 1973;24:1747-51.
61. Baratta R. A double-blind study of cyclobenzaprine and placebo in the treatment of acute musculoskeletal conditions of the low back. Curr Ther Res 1982;32:646-52.
62. Berry H, Hutchinson D. A multicenter placebo-controlled study in general practice to evaluate the efficacy and safety of tizanidine in acute low-back pain. J Int Med Res 1988;16:75-82.
63. Gold R. Orphenadrine citrate: sedative or muscle relaxant? Clin Ther 1978;1:451-3.
64. Hindle T. Comparison of carisoprodol, butabarbital, and placebo in treatment of the low back syndrome. California Med 1972;117:7-11.
65. Klinger N, Wilson R, Kanniainen C, et al. Intravenous orphenadrine for the treatment of lumbar paravertebral muscle strain. Curr Ther Res 1988;43:247-54.
66. Wörz R, Bolten W, Heller J, et al. Flupirtin im vergleich zu chlormezanon und placebo bei chronische muskuloskelettalen rückenschmerzen. Fortschr Ther 1996;114:35-6.
67. Casale R. Acute low back pain: symptomatic treatment with a muscle relaxant drug. Clin J Pain 1988;4:81-8.
68. Dapas F. Baclofen for the treatment of acute low-back syndrome. Spine 1985;10:345-9.
69. Boyles W, Glassman J, Soyka J. Management of acute musculoskeletal conditions: thoracolumbar strain or sprain. A double-blind evaluation comparing the efficacy and safety of carisoprodol with diazepam. Today's Ther Trends 1983;1:1-16.
70. Rollings H. Management of acute musculoskeletal conditions-thoracolumbar strain or sprain: a double-blind evaluation comparing the efficacy and safety of carisoprodol with cyclobenzaprine hydrochloride. Curr Ther Res 1983;34:917-28.
71. Berry H, Hutchinson D. Tizanidine and Ibuprofen in acute low-back pain: results of a double-blind multicenter study in general practice. J Int Med Res 1988;16:83-91.
72. Borenstein D, Lacks S, Wiesel S. Cyclobenzaprine and naproxen versus naproxen alone in the treatment of acute low back pain and muscle spasm. Clin Ther 1990;12:125-31.
73. Hingorani K. Diazepam in backache: a double-blind controlled trial. Ann Phys Med 1966;8:303-6.
74. Tervo T, Petaja L, Lepisto P. A controlled clinical trial of a muscle relaxant analgesic combination in the treatment of acute lumbago. Br J Clin Pract 1976;30:62-4.
75. Sweetman B, Baig A, Parsons D. Mefenamic acid, chlormezanone-paracetamol, ethoheptazine-aspirin-meprobamate: a comparative study in acute low back pain. Br J Clin Pract 1987;41:619-24.
76. Hingorani K. Orphenadine/Paracetamol in backache: a double-blind controlled trial. Br J Clin Pract 1971;25:227-31.
77. Götzsche PC. Reference bias in reports of drug trials. Br Med J (Clin Res Ed) 1987;295:654-6.
78. Van der Kuy A. Farmaco-therapeutisch Kompas. ZiekenfondsRaad: Amstelveen; 1997.
79. Elenbaas JK. Centrally acting oral skeletal muscle relaxants. Am J Hosp Pharm 1980;37:1313-23.
80. Faas A, Chavannes AW, Koes BW, et al. NHG-standaard lage rugpijn. Huisarts Wet 1996;188-99.
81. Waddell G, Feder G, McIntosh A, et al. Low Back Pain Evidence Review. London: Royal College of General Practitioners; 1996.
82. Beaton DE, Boers M, Wells GA. Many faces of the minimal clinically important difference (MCID): a literature review and directions for future research. Curr Opin Rheumatol 2002;14:109-14.
83. Testa MA. Interpretation of quality of life outcomes: issues that affect magnitude and meaning. Med Care 2000;38(9 suppl):166-74.
84. Gallagher EJ, Bijur PE, Latimer C, et al. Reliability and validity of a visual analog scale for acute abdominal pain in the ED. Am J Emerg Med 2002;20:287-90.